OUTCOME AND ASSOCIATED FACTORS OF GUILLAIN-BARRE SYNDROME IN SELECTED ADDIS ABABA HOSPITALS, ETHIOPIA

Abstract

ABSTRACT Background: Guillain-Barré syndrome (GBS) represents an aberrant autoimmune response to a preceding infection or other immune stimulation, which leads to ascending symmetric weakness or paralysis which may ascend to the diaphragm, compromising respiratory function and requiring mechanical ventilation in one third of patients. Data on GBS from Ethiopia studies is limited. And given the poor hygiene and sanitation along with frequent exposure to pathogens that render populations in low-income and middle-income countries like Ethiopia prone to outbreaks of infectious diseases that can trigger GBS, it is important to assess the burden of the problem and treatment outcome and factors that are associated Objective: The objective of this study is to assess the outcome and associated factors of GBS in selected hospitals of Addis Ababa. Methodology: A retrospective chart review of GBS patients admitted from January 2020 – December 2022 in selected Addis Ababa hospitals was conducted. Whole take sampling was used for selecting the study participants and a structured questionnaire was used for data collection. Data was entered in Epi Info version 7.1 and analysed using SPSS by binary logistic regression and multiple logistic regression models. Result: A total of 124 participants were included in the study. Among the total participants most 84 (67.7%) were males. The age of participants ranged from 2-75 years and the mean age was 29.8 years (SD: 20.6). The most common preceding event was respiratory tract infection, accounting for 29.8% followed by gastroenteritis in 29%; whereas 29% of the patients had no any preceding event. The most common clinical presentation was ascending paralysis 119 (95.6%) and the most common finding on NCS was AMAN 18 (14.5%) followed by normal, AIDP and AMSAN, 9.7%, 5.6% and 3.2% respectively. 68.5% of the cases had bad outcome based on the Hughes motor scale of the GBS disability grading. The odds of having good outcome was found to be 0.24 times less in those participants who have gastroenteritis as a preceding event (AOR: 0.24, 95% CI: 0.069-0.823) than those who had no preceding event. Those participants who needed mechanical ventilation were found to be 0.12 times less likely to have good outcome than those who don’t (AOR: 0.12, 95% CI: 0.023-0.604). Conclusion and recommendations: This study showed that bad outcome in GBS patients is high. And since respiratory tract infections and gastroenteritis were the main preceding events, with gastroenteritis being associated with bad outcomes, hospitals and health care providers should work on infection control strategies including gastroenteritis among the public. Key words: Guillain–Barré Syndrome, Treatment outcome